Breech Flashcards
what is a frank breech?
A frank breech is the most common presentation with the hips flexed and knees fully extended.
what is a footling breech?
where one or both feet come first with the bottom at a higher position, is rare but carries a higher perinatal morbidity
risk factors for breech
uterine malformations
fibroids
placenta praevia
polyhydramnios or oligohydramnios
fetal abnormality (e.g. CNS malformation, chromosomal disorders)
prematurity (due to increased incidence earlier in gestation)
how common is a cord prolapse in breech presentations?
common
what is the Mx if < 36 weeks
nothing most foetuses will turn themselves
what do you do if they are still at breech at 36 weeks?
Recommends external cephalic version - success rate of 60%
at how many weeks should external cephalic version be offered?
from 36 weeks in nulliparous women
37 weeks in multiparous women
what do you do if still after an external cephalic version the baby is still in breech?
c section
vaginal
contraindications to external cephalic version
where caesarean delivery is required
antepartum haemorrhage within the last 7 days
abnormal cardiotocography
major uterine anomaly
ruptured membranes
multiple pregnancy
